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At first, CPAP patients should be monitored in a sleep lab to determine the appropriate amount of air pressure for them. The first few nights on CPAP tend to be difficult, with patients experiencing less sleep. Many patients at first find the mask uncomfortable, claustrophobic or embarrassing. CPAP is not a cure and must be used every night for life. Non-compliant patients experience a full return of obstructive sleep apnea and related symptoms.

CPAP patients during sleep wear a face mask connected to a pump that forces air into the nasal passages at pressures high enough to overcome obstructions in the airway and stimulate normal breathing. The airway pressure delivered into the upper airway is continuous during both inspiration and expiration.

Nasal CPAP is currently the best treatment for severe obstructive sleep apnea. CPAP is safe and effective, even in children. Tissues are prevented from collapsing during sleep, and apnea is effectively prevented without surgical intervention. Daytime sleepiness improves or resolves. Heart function and hypertension also improve. And, importantly, the quality of life improves.

Continuous Positive Airway Pressure (CPAP) provides one constant air pressure all through the night

Automatic Positive Airway Pressure (APAP) therapy automatically varies the pressure all through the night and from night to night. It actively responds to the continuous changes in the upper airway of your patient.

Bilevel Therapy (VPAP, BiPap) provides a higher pressure when the patient inhales, and a lower pressure when they exhale.

Oxygen Therapy

If you need Oxygen Therapy at home, it is important to learn how to use it and take care of your equipment. This information will help you get the most from your Oxygen Therapy.

Key points
Breathing extra Oxygen can help you feel better and lead a more active life.
You can travel even though you use Oxygen, but you will need to plan ahead.
Oxygen is a fire hazard. It is important to follow safety measures to keep you and your family safe.
Oxygen Therapy is a way to increase the amount of Oxygen in the lungs and the bloodstream. It is sometimes used for people with diseases that make it hard to breathe, such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, or heart failure. Oxygen Therapy can make it easier to breathe and reduce the heart’s workload.

Some people need extra Oxygen all the time. Others need it from time to time throughout the day or overnight. A doctor will prescribe how much Oxygen you need, based on blood tests. He or she will tell you how much Oxygen to use per minute (flow rate) and how often to use it.

To breathe the Oxygen, most people use a nasal cannula (say "KAN-yuh-luh"), a thin tube with two prongs that fit inside your nostrils. Children and people who need high levels of Oxygen may need to use a mask that fits over the nose and mouth.

Oxygen can be delivered to your home in tanks, or cylinders, or it can be produced in your home by a machine called an Oxygen Concentrator. Your doctor will help you choose the source that fits your needs. A combination of methods may be the best choice. Some people use an Oxygen Concentrator at home, keep a large Oxygen tank on hand as a backup, and have small tanks for use outside the home.

Oxygen in tanks comes in two forms:
Compressed Oxygen gas. Tanks of Oxygen gas come in several sizes. Small tanks can be carried when you leave home. Large tanks are heavy and are usually not moved after they are placed in the home.
Liquid Oxygen. Oxygen takes up less space in liquid form than as a gas. Compared to tanks of Oxygen gas, tanks of liquid Oxygen weigh less and hold more Oxygen, so they may be a good choice for people who are active."

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Here's the problem....
Oxygen is delivered to the brain via blood-- which is infused with O2 by the lungs.

The lungs serve to exchange the two gases in the blood. Oxygen enters the blood from the lungs and carbon dioxide is expelled out of the blood into the lungs. The blood serves to transport both gases. Oxygen is carried to the cells. Carbon dioxide is carried away from the cells.

Cpap and oxygen therapy will increase this level O2, but that's not the root cause of CCSVI hypoxia.

In CCSVI, the issue is the amount of time it takes blood to flow thru the brain, and the amount of blood that is perfusing brain tissue. This is called hypoperfusion, and it is a known problem in MS. If deoxygenated blood cannot get out, oxygenated blood does not enter. If perfusion is slowed, the O2 won't reach the brain cells. So, you can have oxygen rich blood that won't touch the deficit in the brain.

Blood transports oxygen and other nutrients necessary for the health of neurons, so a constant flow of blood to the brain must be maintained.

According to Love and Webb,1992, the brain uses approximately twenty percent of the body's blood and needs twenty-five percent of the body's oxygen supply to function optimally. Blood flow in a healthy person is 54 milliliters per 1000 grams of brain weight per minute. There are 740 milliliters of blood circulating in the brain every minute. 3.3 milliliters of oxygen are used per minute by every 1000 grams of brain tissue. This means that approximately 46 milliliters of oxygen are used by the entire brain in one minute. During sleep, blood flow to the brain is increased, but the rate of oxygen consumption remains the same.

Even the recent Swedish study that claimed no CCSVI was found, admitted they saw a lower cerebral blood flow in pwMS...

The closest thing to a significant difference between patients and controls in the findings was in total cerebral blood flow, Sundström and colleagues found. The mean in cases was 723 mL/min (SD 123), compared with 813 mL/min (SD 184) in controls (P=0.073).

Dr. Haacke's MRV protocol is more rigorous and is measuring the difference in cerebral blood flow in pwCCSVI before and after angioplasty, and comparing it with controls. And the difference, when published, will explain alot about the mechanism of brain injury in MS.
cheer

A cpap wouldn't help, but anything like an oxygen compressor might. If you can elevate your blood oxygen higher than normal, perhaps the brain has a chance of getting normal levels of oxygen, even for a time. Like an infusion before it has to go back to the daily deprivation. Better though just to get the venoplasty done!

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